Starting treatment...and giving up?

2) My girlfriend finally made it into a PHP treatment program. She has almost finished her second week and is ready to quit. Apparently she has to think about it tonight and then let them know tomorrow what she will do. They do not believe she is strong enough to do PHP, and she should probably be in residential, but she refuses. She says that it is "non-negotiable" with her about not graduating on time from her graduate program. She's scheduled to finish in May, but obviously would have to put that on hold if she went into a residential treatment program. She's going for her MSW, which feels ironic to me right now, because if she cares about mental health as much as I know she does (so much that she wants to be a care provider) then why would she not be willing to put her graduation on hold for just a few months so that she could get life-saving treatment?!?!?!

What the HECK am I supposed to do with this? I am at a loss right now. I've been working very hard with my therapist and on my own to separate my mental health from her illness and situation. But right now, with this information being thrown on me, I am just scared for her. She told me that she is having suicidal ideations right now, and I am at work. She doesn't want me to be with her tonight after I get off work because she wants to be able to think about what she is going to say and do tomorrow as far as her treatment plan goes. But if she does something to herself today I will be devastated.

Obviously, a lot of this is about control. I know that she feels so out of control with her treatment program, and that is a scary feeling for her. I am completely out of control as far as what is happening now, and that's scary too.

This definitely sounds like a complicated situation; please know that you're in our thoughts--sending positive vibes your way!! It can be so hard to convince someone to make the commitment to a higher level of treatment. It is a big step and it means putting some things on hold, plus the "ED voice" can really fight back against it. But you're on the outside and you can see the situation more objectively so you see the benefits of stepping up treatment. It sounds like you're frustrated and confused, and that's definitely understandable.

I want to say that I think it's awesome that you're working so hard with your therapist to take care of your own mental health. When a loved one has an ED, many people end up putting their own concerns on the back burner, but this isn't sustainable in the long run. It does sound like things are particularly stressful at the moment, so it makes sense to be overwhelmed and frightened by what she's going through. Would it work for you to offer to spend time with her tonight, but give her some space and quiet to think about her treatment plan? You could even watch a movie or TV show so that you can be together but not necessarily actively talking about the situation the entire time--that might be a helpful compromise so you can check in on her.

It does sound like a difficult situation, and you're right that a lack of control can be scary--my thoughts are with you. I wish I had answers for you. Try to focus on getting through one day (or one hour, or one minute) at a time. Please keep us updated on how things go!

I also want to share some resources with you, and you can pass these along to your girlfriend:
National Suicide Prevention Lifeline 1-800-273-8255 (and online chat: https://suicidepreventionlifeline.org)
For crisis situations, text "NEDA" to 741741 to be connected with a trained volunteer at Crisis Text Line.

I guess the first question is if the school would give her time off to do the program, and allow her to take up her studies again when she returns. While she may find herself freaking out at the moment, possessing the hard facts about this is something that may help calm her down.

Otherwise…people with EDs can be extra-sensitive, when it comes to concepts involving success and failure. It's that darned "good enough" thing and the "being in control" thing too. Plus folks can be vulnerable to black and white thinking as well : It's gotta be all or nothing you know ? Or success or failure, as seems to be her defining worries right now.

Still, I suspect she would agree, as part of her studies, that it's healthy for a person to allow some healthy flexibility into their lives at times too. Which in this instance may apply to things like allowing herself to do her treatment program.

My sense is that she understands all of this already, but even so, there can still be that big mental war between control and flexibility that really can continue to plague a person, and it kind of sounds like that's what she finds herself up against now. Even to the point where all that ideation starts popping up.

I'm not sure how we can help people loosen up a little, in the ways that they need to do in situations like this, but it might be something the two of you could talk about. Granted she may already know it, but still, just being able to talk openly about it can help sometimes.

In the mean time, all best wishes back to you. As someone once said, this really isn't the club that anyone wants to join, but even so, it's good to see some familiar names here now and then. :-)

Today she will make her decision about furthering treatment, or leaving it behind. As of right now, she is still undecided. I wish that she would consider residential, but that option seems to be "non-negotiable" still. I have noooo idea how to support her in this time. It will be very hard to support my partner as they make a conscious decision to begin suppressing emotions, partaking once again in her ED, and avoiding any type of treatment whatsoever. How do people do that? Any suggestions?

I know what you mean about this, from the time I spend dealing with people in her situation. We have our own pretty good ideas of what they should do, but at the same time it's a decision that has to be theirs, and that they need to make for themselves. So yeah, what can we say that's constructive and empathetic, but which avoids invalidating our position by making it sound like we'll be judging them, or that we are trying to manipulate their decision ?

For myself I always go to my fall-back position, which is trying to put myself in their shoes :

" I know it must be hard to make this decision. " Which is only stating the truth.

"It must be difficult to know how to feel about this." Another statement which is most likely true.

Granted, statements like these are not going to influence what decision she makes, but they *are* supportive. And being supportive is our legitimate role.

I know you must be thinking about how this decision may effect things in the future".

This statement is a bit more loaded it's true, but is probably still an accurate one. She knows well enough that deciding to not deal with her ED will indeed effect things in the future. So should she deal with it now, or allow it to keep effecting things ? My sense is that as someone who's hoping to be a therapist herself, she knows that this is a proper matter to consider.

In any case, "being supportive" is often a quite different ballgame than telling the person what *we* think they should do. But it can still have a positive effect I believe.

The way I look at it is that mostly people want to be heard, and people want to be known. And that being told what to do is much further down the list from those things, when it comes to helping them feel good about their interactions with us.

I think she is staying in treatment, so far. She is determined to be finished before her internship starts in August, though. I disagree with this decision but at this point I need to take what I can get as far as her treatment goes, I think. I have been asking her to consider putting off school for a bit so that she can tackle this, because putting a timeline on her healing is not going to work. It's still a non-negotiable as of now...

She is still in a very low place so that is unfortunate, but I am hoping that she will get into a healthier pattern as treatment continues.

I appreciate the kind words of encouragement. This message board has been so helpful for me.

Yep, when we see someone feeling pressured, or setting their recovery on some kind of a timeline, it's something we can worry about, that's for sure. And sorry to hear that she's feeling so down right now too. It's better when people allow themselves to feel some hope, but it doesn't sound like she's in that kind of space yet. As you implied, perhaps in part because she's putting so much pressure on herself ?

Hopefully the folks she's working with in treatment are picking up on this dynamic, and will urge her to be a little more gentile and self-forgiving about all this. Those sorts of kind-hearted feelings towards one's self are essential to recovery I always think.

My 15-year old daughter just got admitted to a residential treatment facility this week and she has been calling us crying, miserable saying she does not belong there. Her ED is she restricts then binge then purge through over exercising and use of laxative. She is also diagnosed with depression. The week prior to her admission to the residential treatment, she showed some signs of progress with her mood and eating habits. I started to doubt whether going to an intensive facility will be too much for her. Now, she's there and she feels like they are over feeding her (3 meals and 3 snacks/day) and she is worried that without exercise she will be gaining weight (which is her worst fear). Her current body weight is really not an issue but in her mind it is. She is complying with all the program to get a check off so that she can go home soon but she keeps calling us to pick her up. My concern is her current mental state, she sounded very lonely and depressed. I don't want her to get more depressed. Not sure what to do! Please help!

While this may not be helpful, I just wanted to mention that what you and your daughter are going through is *really* common. Off they go to the treatment place, and then come all the desperate and panicky phone calls !! Honestly, treatment places need to forewarn parents about this so that they'll be prepared for it when it comes. This flavor of panic is a very common reaction, when people first find themselves in treatment.

Part of it is that everything they are being asked to do feels absolutely and totally wrong. Eating itself feels wrong, having other people control their food choices feels wrong, and it just never stops ! It seems like you just managed to finish some breakfast that seemed *way* too large, and then they want you eating some snack !! Having food being pushed at you from morning 'till night ! People really can get in a panic in situations like that.

Fortunately, most people get over it. Ten days to 2 weeks seems to be how long it usually takes before their panic begins to let up a little. But in the mean time, they legitimately do feel desperate, and they do feel like hatching some kind of plan to get out of there.

What you can do is to try and stay calm. That sounds kind of simplistic I know, but somebody needs to be "the rock", if you know what I mean ? You can't really tell her that things will get better, as that's a thing that she'll need to feel on her own. But you can have some sympathy for her distress, and the feelings of "wrongness" that she's feeling now.

Also, I'm not sure how the phone situation is there, but if you have an idea of when she usually calls, you might try calling her before she calls you ? That would show your good intentions as well.

Otherwise, I'd give it 10 days or 2 weeks, before you really start to worry about whether she'll be able to tolerate it there or not. In my experience, most people in treatment seem to settle into things by then.